Objective

To investigate whether multi-shot diffusion-weighted imaging (ms-DWI) could be applied in diagnosis and quantitative evaluation of cervical spondylotic myelopathy (CSM).

Methods

Thirty-three normal volunteers and 78 patients with CSM were included in this study. The apparent diffusion coefficient (ADC) values were measured at C2–C7 levels on sagittal section ADC map. The intraclass correlation coefficient (ICC) and Bland and Altman plot and Spearman coefficient were used to quantify the reproducibility of test and retest and inter-rater reliability. Pearson correlations were calculated to compare lADC and rADC versus mJOA and NDI scores. Receiver operating characteristic curve and the area under the curve (AUC) were applied to evaluate the diagnostic reliability.

Results

There was no statistically significant difference between ADC values obtained from normal volunteers at C2–C7 levels (P < 0.05). The ICC and spearman coefficient of lADC and rADC indicated excellent test–retest and inter-rater reliability. The mean lADC and rADC were significantly higher from patients than that from volunteers (all P < 0.01). The lADC had moderate to good correlations with mJOA and NDI (all P < 0.0001). Moreover, rADC had good to excellent correlations with mJOA and NDI (all P < 0.0001). Comparing AUCs, rADC was significantly superior in diagnosis which participants were CSM than lADC (P = 0.0118).

Conclusion

The ms-DWI could be applied in diagnosis and quantitive assessment of CSM according to lADC and rADC. A new parameter, rADC, could be served as a diagnostic indice for CSM, which may quantitively reflect the severity of CSM.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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多次DWI诊断颈椎病性脊髓病的信度和效度：基于3-T MRI的研究。

目的

目的探讨多层扩散加权成像（ms-DWI）是否可用于颈椎病性脊髓病（CSM）的诊断和定量评估。

方法

该研究包括33名正常志愿者和78名CSM患者。视在扩散系数（ADC）值是在矢状截面ADC图上以C2-C7的水平测量的。使用组内相关系数（ICC）以及Bland和Altman图以及Spearman系数来量化测试和重新测试的可重复性以及评估者之间的可靠性。计算皮尔逊相关性以比较lADC和rADC与mJOA和NDI得分。使用接收器工作特性曲线和曲线下面积（AUC）评估诊断可靠性。

结果

从正常志愿者在C2-C7水平获得的ADC值之间无统计学差异（P  <0.05）。lADC和rADC的ICC和spearman系数显示出极好的重测和评估者间可靠性。患者的平均lADC和rADC显着高于志愿者（所有P  <0.01）。lADC与mJOA和NDI有中等到良好的相关性（所有P  <0.0001）。此外，rADC与mJOA和NDI的相关性非常好（所有P  <0.0001）。与AUC相比，rADC在诊断方面显着优于那些参加CSM的患者（1  = P = 0.0118）。

结论

根据lADC和rADC，ms-DWI可用于CSM的诊断和定量评估。一个新的参数rADC可用作CSM的诊断指标，它可以定量反映CSM的严重性。

图形摘要

这些幻灯片可以在电子补充材料下找到。